Tom 3, Nr 3-4 (2023)
Wytyczne / stanowisko ekspertów
Opublikowany online: 2023-08-29
Standaryzacja wielokolorowej cytometrii przepływowej w diagnostyce ostrych białaczek limfoblastycznych u dzieci — wytyczne grupy AIEOP-BFM
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DOI: 10.5603/hemedu.95478
Hematologia - Edukacja 2023;3(3-4):104-117.
Streszczenie
Immunofenotypowanie za pomocą cytometrii przepływowej (FCM) jest obecnie jedną z podstawowych metod diagnostycznych w rozpoznawaniu ostrych białaczek. Jednakże wieloośrodkowe dane pokazują pewne braki i niespójności między obowiązującymi klasyfikacjami, standaryzacją technologiczną a ich wdrożeniem do praktyki klinicznej. Grupa Associazone Italiana Ematologia Oncologia Pediatrica-Berlin–Frankfurt–Münster, w skład której wchodziło 9 europejskich ośrodków referencyjnych w diagnostyce immunofenotypowej białaczek u dzieci, opracowała wytyczne mające na celu walidację i standaryzację samej metody oraz — co ważniejsze — wypracowała również wspólne wytyczne opisujące wdrożenie możliwości wielokolorowej FCM do praktyki klinicznej. Przedstawiono wymagania dotyczące panelu diagnostycznego, systemu bramkowania blastów, kontroli wewnętrznej, trójstopniowej oceny ekspresji antygenów, opisu heterogenności komórek blastycznych i tworzenia subklonów, dopracowano immunologiczny system klasyfikacji ostrych białaczek limfoblastycznych oraz algorytm postępowania w ocenie linii dominującej w przypadkach białaczek dwuliniowych lub ze złożonym immunofenotypem, co ma decydujące znaczenie w doborze odpowiedniego leczenia. Niniejsze wytyczne są ważnym krokiem w kierunku niezbędnej standaryzacji międzylaboratoryjnej diagnostyki immunofenotypowej białaczek u dzieci, stosunkowo łatwym do wdrożenia w laboratoriach diagnostycznych oraz ułatwiającym prowadzenie wieloośrodkowych badań klinicznych. Celem niniejszej pracy jest rozpowszechnienie w Polsce przedstawionych wytycznych. Umożliwi to sprawniejsze porównywanie wyników między ośrodkami oraz ułatwi ich interpretację przez lekarzy klinicystów w sytuacjach wieloośrodkowej opieki nad pacjentem, na przykład w jednostkach diagnostycznej, leczniczej i transplantacyjnej.
Słowa kluczowe: standaryzacjacytometria przepływowaimmunofenotypowanieostra białaczka limfoblastyczna u dzieci
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